Anti-Inflammatory and Pro-Inflammatory Neuropeptides in Dilative Cardiomyopathy are there Relations to Psychophysical Stress?

Norbert Klein*¹, Dietrich Pfeiffer² Stefan Dhein³, Maika Klein² and Aida Salameh³

Received: September 4, 2018;   Published: September 10, 2018

DOI: 10.26717/BJSTR.2018.08.001716

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Abstract

Background: Neuropeptides can be influenced by psychophysical stress and may have influence on cardiac function. Objective: We wanted to find out, whether pro- and anti-inflammatory neuropeptides may be altered in heart failure (HF) and may be modulated by psychophysical stress.

Methods: Therefore, 29 patients of both gender suffering form heart failure (NYHA II-III) or and 20 healthy volunteers were investigated for the levels of the pro-inflammatory neuropeptides TNFα, IL-6, IL-2, IL-1β and IL-12, and of the anti-inflammatory neuropeptides GHrelin, urocortin, adrenomedullin and VIP as well as for TH1, TH2, TH17, CD4 and CD4CD25 cells. Left ventricular (LV) ejection fraction (LVEF), end-diastolic and end-systolic diameter (LVEDD; LVESD) were assessed echocardiographically. Psychophysical stress and quality of life was evaluated by the SF-36 questionnaire.

Results: In NYHA II- and III-patients urocortin, adrenomedullin and VIP were elevated, while Ghrelin, TNFα, IL-12 and IL-2 were unchanged. IL-6 was slightly elevated and IL-1β was slightly reduced in NYHA II. TH17 cells were reduced, while TH1, TH2 and CD4 were unchanged. CD4CD25 were slightly increased. SF-36 questionnaire revealed nearly unchanged emotional and social functioning while the physical role functioning was reduced in HF-patients.

Conclusion: HF is associated with reduced quality of life as concerning physical role functioning, reduced ventricular performance and alterations of the balance between pro- and anti-inflammatory neuropeptides so that pro-inflammatory TH17 cells are reduced. Since neuropeptides also can affect cardiac output, these results indicate the activation of a neuropeptide-heart axis in HF, yet unknown. Socio-emotional stress does not seem to account for the changes.

Declaration: there is no conflict of interest of any author with any third party to declare.

Keywords: Neuropeptides; Adrenomedullin; Phenotyping Kit; Heart Failure; Hyperthyreosis; Amyloidosis; Gravidity; Implantation; Left Ventricular; Quality of Life

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